Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.81 / $183.02 / $308.38	Facility		$109.81	$183.02	$308.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.45 / $103.75 / $315.00	Professional		$58.45	$103.75	$315.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $108.00 / $120.00	Facility		$75.00	$108.00	$120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.58 / $127.74 / $265.20	Professional		$74.58	$127.74	$265.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.24 / $223.07 / $257.27	Professional		$162.24	$223.07	$257.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.84 / $109.81 / $240.65	Facility		$83.84	$109.81	$240.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $161.72 / $257.02	Professional		$115.65	$161.72	$257.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $117.30 / $168.72 / $201.67	Facility		$117.30	$168.72	$201.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.84 / $108.00 / $240.65	Facility		$83.84	$108.00	$240.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $98.91 / $178.85 / $265.20	Professional		$98.91	$178.85	$265.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $149.12 / $269.64 / $393.38	Facility		$149.12	$269.64	$393.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $122.01 / $273.60	Professional		$107.76	$122.01	$273.60
United Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $87.70 / $213.58	Professional		$78.93	$87.70	$213.58